diabetes

Question 1

insulin pumps are usually given too

Answer 1

TYPE 1

Question 2

what is a job of insulin pump

Answer 2

is to mimic the body in production of the baseline insulin

Question 3

if you are type 2 diabetic what type of insulin will you generally need

Answer 3

intermediate/long acting since you still have some function

Question 4

side effects of insulin

Answer 4

can drop levs too low causing hypo

due to anabolic hormone causes lip hypotrophy so always change sites of injection

Question 5

alcohol and diabtes relationship

Answer 5

drinking increases risk of type 2 diabtest

generally alcohol raises blood sugar as it has a lot of calories and can lead to weight gain

however if you are taking insulin and alcohol your risk of hypoglycemia is increased as it prevents the liver from releasing the excess glucose stored.

Question 6

hypoglcyemia
tx

Answer 6

usually below 4 mmol

glucogel
glucose or dextrose tablets

if unconscious glucagon injection

Question 7

ideal hb1ac for a diabetic is

why do we care about the levels

Answer 7

6.5%

because over the hreshold you are at risk of complications relared to diabets

Question 7

what is hb1ac

Answer 7

test for diagnosing type 2, or lookingat how well controlled your type 2 is looks at your rbc for the last 3 months and how controlled your blood sugars are

once the glucose binds to the rbc it stays there so you know.

Question 9

hb1ac vs normal blood test

Answer 9

normal : looks at your sugar now

hb1 ac _ in the past 3 moths

Question 10

c peptide

Answer 10

is in direct proportiion to the amount of insulin so helps differentiate between type 1 and type 2 not really a diagnostic tool

Question 11

what other confition is closely linked to type 1

Answer 11

thyroid disease

Question 12

random glucose over ?

Answer 12

11

Question 13

high glycemic index

Answer 13

cause a rapid spike in insulin levels so short

Question 14

sick day rules and why

Answer 14

when you are ill your blood sugar increases as a way to cope with the stress, in normal people the body just produces more insulin to counter the effects.

so diabetes who are ill will often high higher levels than usual

its important not to stop taking insulin

to keep eating/hydrating

pt should regularly check their glucose levles

Question 15

normal gfr

Answer 15

> 90

Question 16

side effects of metfrmine

Answer 16

gi upset- will stop if they perists

lactic cidosis risk increased with renal problems

Question 17

microvascular complications -daibtes

Answer 17

nephro
retinopathy
neuropathy

Question 18

macrovascular diabetes

Answer 18

brain
pvd
heart

Question 19

different types of insulin

Answer 19

rapid acting - usually 15 mins before

short acting - usually 30 mins before
intermediate
long acting

Question 20

what is mixed insulin

Answer 20

you take mixed insulin, that means you take it before meals and don’t need to take background (or basal) insulin at a different time.

Question 21

signs of diabetes

Answer 21

polyuria
dipsia
polyphagia
loss of weight
numbness/pareesthia
autonomic dysfunction - urinary (nerves that empty bladder reduced so can leas to retention and hence UTI increased and sometimes incontinence)
erectile dysfunction , bowels
orthostatic hypo
gastroporiss
sweat glands - both

Question 22

group of drugs

Answer 22

biguinides - metformin

sulfonoreus - glicazide

SGLT- dapaglipozin

DPP4 inhibitors - stigaliptin

Question 23

1st 2nd line

Answer 23

1. metformin
2. glicazide
   3.

Question 24

Which is more important in the management of type 2 diabetes; blood pressure control or blood glucose control

Answer 24

bP control

Question 25

why does diabetes increase risk of stroke

Answer 25

sugar damages the walls of the vessels

this increases the risk of atherosclerosis

having diabtes also increases risk of clot formation affects the clotting factors

also havng diabtes also increases the risk of hypertension which is a rf for stroke

Question 26

what is the major cause of death in people with type 2 diabetic

Answer 26

cardiovascular disease

Question 27

What is the normal glycated haemoglobin level for non-diabetic

Answer 27

less than 6%

Question 28

Something we really want to focus on in a patient that has diabetes

Answer 28

But pressure control is even more important than sugar control

Question 29

Destinations you would perform to diagnose somebody with diabetes

Answer 29

Random blood glucose ≥ 11.1mmol/l
Fasting plasma glucose ≥ 7mmol/l
2-hour glucose tolerance ≥ 11.1mmol/l
HbA1C ≥ 48mmol/mol (6.5%)

Question 30

for diabetics with hypertension whats first line

Answer 30

ace as they are renoprotective

Question 31

target range for blood pressure

Answer 31

<140/90 - same for normal people under 80

Question 32

target bp for people over 80

Answer 32

<150/90

Question 33

how to reat gastropereis

Answer 33

need to stimulate motility so metoclorpromide and domperidone

sometimes it can actually be cause by bacteria so abx are given